HESI RN
HESI Leadership and Management
1. An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump:
- A. Gives small continuous doses of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal.
- B. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals.
- C. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream.
- D. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels.
Correct answer: A
Rationale: The correct answer is A. An external insulin pump delivers small continuous doses of regular insulin subcutaneously throughout the day to meet the basal insulin needs. The client can also self-administer a bolus dose with an additional dosage from the pump before each meal to cover the mealtime insulin needs. Option B is incorrect as insulin pumps do not typically release programmed doses of insulin into the bloodstream at specific intervals; instead, they infuse insulin subcutaneously. Option C is incorrect as insulin pumps are not surgically attached to the pancreas; they are worn externally. Option D is incorrect as NPH insulin is not commonly used in insulin pumps, and the pumps do not continuously infuse insulin directly into the bloodstream but rather subcutaneously.
2. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?
- A. Tap water
- B. Sterile water
- C. Sodium chloride
- D. Normal saline
Correct answer: C
Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.
3. A client with type 1 DM is experiencing hypoglycemia. Which symptom should the nurse expect to observe?
- A. Tachycardia
- B. Polyuria
- C. Flushed skin
- D. Dry mouth
Correct answer: A
Rationale: The correct answer is A: Tachycardia. In hypoglycemia, the body releases adrenaline in response to low blood glucose levels, leading to symptoms such as tachycardia (rapid heart rate). Choice B, polyuria, refers to excessive urination and is not a typical symptom of hypoglycemia. Choice C, flushed skin, is not a common symptom of hypoglycemia; instead, pale skin and sweating are more characteristic. Choice D, dry mouth, is not directly associated with hypoglycemia; rather, it can be a symptom of hyperglycemia or dehydration.
4. The healthcare provider is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings is most consistent with this condition?
- A. Increased serum sodium
- B. Decreased urine specific gravity
- C. Decreased serum osmolality
- D. Increased serum potassium
Correct answer: C
Rationale: The correct answer is C: Decreased serum osmolality. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. The dilution of sodium results in decreased serum osmolality. Option A is incorrect because SIADH causes hyponatremia, resulting in decreased serum sodium levels. Option B is incorrect because SIADH leads to concentrated urine with increased urine specific gravity. Option D is incorrect as SIADH does not typically affect serum potassium levels.
5. Which of the following best defines management?
- A. A manager is someone who ensures that employees complete their work.
- B. A manager controls the work of employees.
- C. A manager organizes and controls a group of employees to get work done.
- D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.
Correct answer: D
Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.
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